Nobody Gets Out of Here Alive

You can deny the inevitable but not defy it—still there are a few compensations to growing old

By

Joseph Epstein

Updated Jan. 29, 2011 12:01 a.m. ET

Babe you may be beautiful: You got to

die some day

So you well as to give me some of yourloving: Before you pass away

—Old blues song

We are all bornwith a serious and unalterable defect: We grow old—at least the lucky among us do—and then we die. Some attribute this to the decisive side-effect of the poor judgment Eve showed in the Garden of Eden; some to the breakdown in the plot of evolution, which appears to have creaked to a halt before finishing the job and rendering human beings both perfect and immortal. Whichever the case, we are left with the appalling inconveniences of aging and the unavoidable fact of death.

Aided by careful diet, nearly constant exercise, serene thoughts and relentless medical discovery, there are those who attempt to deny death. They are counting on longevity without surcease. These people and their optimistic thinking are the targets of Susan Jacoby's "Never Say Die."

Ms. Jacoby is herself 65 years old, and thus at the older end of the generation known as baby boomers, who, she feels, are especially loath to admit to growing older, let alone to dying. Not a generation, the boomers, to heed Homer, who advised, "Best not to be born, or to die young"; or for that matter Xen o phon's Socrates, who submits to death tranquilly because he thinks it preferable to old age (which Trotsky, before meeting with death through assassination by ice pick, called "the most unexpected thing of all that happens to man").

Boomers and other death-deniers find succor in all the heartening health news—and every television station and newspaper now has an editor or reporter or two purveying it—that brings hopeful new cures for old diseases and successful longevity experiments on mice and other critters. They gobble up stories in the New York Times of a 90-year-old woman tossing javelins, Elliott Carter composing music at 100 and other elderly folks who, after putting down half a carafe of red wine, enjoy a good smoke and perhaps a robust bonk. Death they've heard of but don't quite believe in, not really, at least not for themselves. For them "old" is a psychologically, if not politically, incorrect word, and one expunged from their vocabulary.

In her book, Ms. Jacoby serves as a reality instructor. Bad news flows from her as profanity from a rap group. And bad news is what she has for all who believe that, because longevity has doubled since the middle of the 19th century—this owing chiefly to improved sanitary and environmental conditions—there is no good reason for its not continuing to climb upward, ever upward. She reports, for example, that of all who attain the stately age of 85, fully half will have that stateliness snuffed out by Alzheimer's; and, more wretched news, there is a strong chance they will also end up in a nursing home with some other dread medical affliction or other.

Imagine a modern-day Cassandra but one ticked to the max. Ms. Jacoby notes that whenever she hears or reads the phrase "defying old age," it fills her "with rage." In her book, she wishes to underscore "the prevalence of chronic, degenerative, irreversible diseases in advanced old age [that] ought to give pause to those promoting the belief that a long life, if one does everything possible to take care of oneself, is likely to be a healthy, self-sufficient life."

As a contributor on old-age health matters to the AARP bulletin and other magazines and newspapers, she feels that in the past she often idealized aging. "One of the reasons I am writing this book," she avers, "is that I came to feel, especially as I saw the real, not-for-prime-time struggles of much older friends, that I was presenting a half-truth that amounted to a lie."

"Never Say Die" is an attack on self-help health efforts and on the belief that medical technology, like the cavalry in a John Ford movie, will ride to the rescue. Ms. Jacoby goes after doctors and scientists who overpromise, and she shows up the corruption of those who hope to grow rich through one or another kind of Ponce de León pill. She fancies scientists who have a taste for facing unpleasant facts: "Mice are not men," one such says, crushing the hope from all those experiments that promise far longer life in the not-too-distant future. She blasts all media reporting and commercials that make the solutions to aging problems seem only a call to the pharmacy away.

Ms. Jacoby has a chapter on Alzheimer's that will take the curl out of your hair, if you are still young enough to have much remaining. First thing to know is that any cure for this cruel disease, feared only less than cancer, is not near. Exercise, of the body or mind, is no guarantee against it. Nor is inheritance a factor in acquiring it, at least in the case of the disease's late onset. In other words, Alzheimer's is a poisoned dart, raining down, hitting arbitrary targets, for which there is no real protection. She is no more encouraging about stem-cell research, which she is very much for, but wants her readers to understand that the best scientific thought on the subject has the main benefits of such research at least two generations away.

A longtime feminist, Ms. Jacoby expresses anger at her sisters for ignoring the plight of aging for women, especially women living alone. A majority of women will outlive their husbands—two-thirds of those over 85 in America today are women—with diminished finances and in terrible loneliness. "Old age," she writes, "is primarily a women's issue." She also underscores—no surprise here—that aging is even more difficult for the poor, of either gender.

Ms. Jacoby makes no effort to hide or even subdue her politics, which, as you will have already gathered, are liberal, standard left-wing. Brought up a Catholic, she long ago shed any belief in God or the supernatural. This makes it all the easier for her to be a strong advocate of physician-assisted suicide for those among the elderly who have no further interest in living. When people cease believing in God, Chesterton averred, they will believe in anything, and Ms. Jacoby believes in the aid and comfort of the state. After dismally setting out all the agonizing problems of aging, her chief solution for those that might admit of solution is increased taxation that will make possible greater government care. The European model of health care is the name of her desire. Her greater desire, though, is for social justice.

Her barely suppressed rage is aimed chiefly at social injustice of the kind that exacerbates the already difficult problems of aging. Poverty, want of education, the profit motive, gullibility—these are the four horsemen of Ms. Jacoby's apocalypse. She intends, she tells us, "to die angry," and there is little doubt that she is going to achieve her intention, for the social justice of which Ms. Jacoby dreams is likely to come about roughly two weeks after Armageddon, but not a minute before.

The note of anger in "Never Say Die," valorous though it may seem to its author, can be off-putting. By including autobiographical bits in her book—a lover suffering from Alzheimer's, a grandmother and mother forced by old age into retirement and nursing homes—Ms. Jacoby attempts to establish her sensitivity to the problem of aging in general and her virtue in particular. But this doesn't ease the scolding tone of her book. She set out to write an exposé and, because of this tone, ended up with something closer to a tirade. One reads hundreds of long and dense paragraphs without the least relief of wit or any other leavening. "Never Say Die" is relentless in its hammer blows of anger and scorn.

So complete is her attack that she is not prepared to allow the one possible reward of old age, which is the potential for acquiring wisdom through experience. Depression rather than wisdom, she holds, is more likely to be the lot of the old. True, if one is stupid when young or foolish in middle age there is no good reason that wisdom, like Social Security and Medicare, will arrive promptly at 65. Still, one likes to think that the acquisition of considered experience may sometimes bring dispassion, disinterest and thoughtful perspective of the kind that in some quarters passes for wisdom.

ENLARGE

Illustration by Arnold Roth

Never Say Die: The Myth and Marketing of the New Old Age

By Susan Jacoby Pantheon, 332 pages, $27.95

"There is about as much proof of the wisdom of old age as there is of the medical efficacy of holy water from Lourdes," Ms. Jacoby writes. And: "The old-age wisdom canon is essentially a defense against the knowledge of the terrible fates that lies ahead for many of us before we actually die." At this point, in the margin of my copy of "Never Say Die," I scribbled, "Keep the laughs coming, kid."

One departs this book with the impression that the only protection against the depredations and sheer bloody horrors of old age are lots of money or a benevolent government watching out for one. But the experience of aging is richer, more complex, more subtle and philosophically interesting, I fear, than Susan Jacoby, with her feminist's depth and journalist's breadth, can hope to fathom.

Cicero, who had the required depth and breadth, would have strongly disagreed with much in "Never Say Die." A reading of his brilliant essay "On Aging," composed in the form of a dialogue—a work that goes unmentioned by Ms. Jacoby—is the best antidote to her book.

"Cicero," Montaigne wrote, "gives one an appetite for old age." And so he does. Of course old age, bringing with it diminished strength and desires, cannot do some of things youth can; of course old age makes one more prone to illness and disease—parts, after all, do wear out; of course old age puts one closer to death. But weighed beside these serious detractions, Cicero contended, are the opportunities old age brings for "the study and practice of decent, enlightened living," accompanied by a calm that youth, and even middle age, do not allow.

For all the diminishments of old age Cicero set out accompanying consolations. "Great deeds are not done by strength or speed or physique: They are the products of thought, and character, and judgment," he argued. "And far from diminishing, such qualities actually increase with age." The lust of youth is not merely overrated but the seat of much outrage and indecent behavior. "When its campaigns of sex, ambition, rivalry, quarrelling, and all other passions are ended, the human spirit returns to live within itself—and is well off." He added: "The satisfactions of the mind are greater than all the rest."

As for the attribution of such faults among the old as being morose, ill-tempered, avaricious and difficult to please, Cicero claimed, rightly, that "these are faults of character, not of age." Ms. Jacoby argues that "anyone who has outlived his or her passions has lived too long." Cicero, less stringently and stridently, held: "As long as man is able to live up to his obligations and fulfill them . . . he is entitled to live on." I would split the difference and say that the criteria for continuing to live are that one finds life amusing and that there are people in the world who need one.

Unlike Ms. Jacoby, with her penchant for doctor-assisted suicide, Cicero thought with Pythagoras that we mustn't "desert life's sentry-post till God, our commander, has given word." He was of course aware of the arbitrary nature of death, which can strike at any age: "What nature gives us is a place to dwell in temporarily, not to make one's own."

Death, Cicero knew, is an old joke that comes to each of us afresh; and he also knew that old age is a straight man who prepares us, always inadequately, for the punch line. He was himself murdered at 63, by order of his enemy Mark Antony: the hands that had composed attacks against Antony cut off and displayed alongside his head in the Roman Forum. Cicero was wise enough to know that even wisdom itself is no protection against the forces of nature or the malevolence of men.

—Mr. Epstein's "Gossip: The Untrivial Pursuit" will be published later this year by Houghton Mifflin Harcourt.

This copy is for your personal, non-commercial use only. Distribution and use of this material are governed by our Subscriber Agreement and by copyright law. For non-personal use or to order multiple copies, please contact Dow Jones Reprints at 1-800-843-0008 or visit www.djreprints.com.